Fungi in megakaryocytes. An unusual manifestation of fungal infection of the bone marrow

J. A. Ferry, C. K. Pettit, Andrew Rosenberg, N. L. Harris

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

When fungi infect the bone marrow, typically they are associated with granuloma formation and/or necrosis, and the fungi are found within histiocytes or admixed with necrotic debris. Recently two bone marrow biopsy specimens were encountered in which fungi were confined to the cytoplasm of megakaryocytes, a finding not previously reported in the literature. The first case was that of a 46-year-old man with pulmonary histoplasmosis and no known immunodeficiency. The second was that of a 38-year-old man with the acquired immune deficiency syndrome and cryptococcal meningitis. In the first case, many megakaryocytes contained fungal forms consistent with Histoplasma. In the second, one small cluster of megakaryocytes contained several budding yeast consistent with Cryptococcus. Neither marrow biopsy specimen had necrosis, granulomas, or histiocytic infiltration. In both cases, because of the unusual localization of the fungi, they were initially overlooked. The bone marrow may contain fungi even in the absence of abnormalities suggesting fungal infection on routinely stained sections. A silver stain or a periodic acid - Schiff stain should be performed on all marrow biopsy specimens in cases of known or suspected fungal infection outside the marrow. The phenomenon of megakaryocyte emperipolesis is well known, and this process may be responsible for the apparent ability of megakaryocytes to internalize fungi.

Original languageEnglish
Pages (from-to)577-581
Number of pages5
JournalAmerican Journal of Clinical Pathology
Volume96
Issue number5
StatePublished - Jan 1 1991
Externally publishedYes

Fingerprint

Megakaryocytes
Mycoses
Fungi
Bone Marrow
Granuloma
Biopsy
Emperipolesis
Necrosis
Coloring Agents
Cryptococcal Meningitis
Histoplasma
Cryptococcus
Histoplasmosis
Periodic Acid
Saccharomycetales
Histiocytes
Silver
Cytoplasm
Acquired Immunodeficiency Syndrome
Lung

Keywords

  • Acquired immune deficiency syndrome
  • Cryptococcus
  • Emperipolesis
  • Fungus
  • Histoplasma
  • Megakaryocytes

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Fungi in megakaryocytes. An unusual manifestation of fungal infection of the bone marrow. / Ferry, J. A.; Pettit, C. K.; Rosenberg, Andrew; Harris, N. L.

In: American Journal of Clinical Pathology, Vol. 96, No. 5, 01.01.1991, p. 577-581.

Research output: Contribution to journalArticle

@article{0b940b63253b4d378ad4e31333bc0dd1,
title = "Fungi in megakaryocytes. An unusual manifestation of fungal infection of the bone marrow",
abstract = "When fungi infect the bone marrow, typically they are associated with granuloma formation and/or necrosis, and the fungi are found within histiocytes or admixed with necrotic debris. Recently two bone marrow biopsy specimens were encountered in which fungi were confined to the cytoplasm of megakaryocytes, a finding not previously reported in the literature. The first case was that of a 46-year-old man with pulmonary histoplasmosis and no known immunodeficiency. The second was that of a 38-year-old man with the acquired immune deficiency syndrome and cryptococcal meningitis. In the first case, many megakaryocytes contained fungal forms consistent with Histoplasma. In the second, one small cluster of megakaryocytes contained several budding yeast consistent with Cryptococcus. Neither marrow biopsy specimen had necrosis, granulomas, or histiocytic infiltration. In both cases, because of the unusual localization of the fungi, they were initially overlooked. The bone marrow may contain fungi even in the absence of abnormalities suggesting fungal infection on routinely stained sections. A silver stain or a periodic acid - Schiff stain should be performed on all marrow biopsy specimens in cases of known or suspected fungal infection outside the marrow. The phenomenon of megakaryocyte emperipolesis is well known, and this process may be responsible for the apparent ability of megakaryocytes to internalize fungi.",
keywords = "Acquired immune deficiency syndrome, Cryptococcus, Emperipolesis, Fungus, Histoplasma, Megakaryocytes",
author = "Ferry, {J. A.} and Pettit, {C. K.} and Andrew Rosenberg and Harris, {N. L.}",
year = "1991",
month = "1",
day = "1",
language = "English",
volume = "96",
pages = "577--581",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
publisher = "American Society of Clinical Pathologists",
number = "5",

}

TY - JOUR

T1 - Fungi in megakaryocytes. An unusual manifestation of fungal infection of the bone marrow

AU - Ferry, J. A.

AU - Pettit, C. K.

AU - Rosenberg, Andrew

AU - Harris, N. L.

PY - 1991/1/1

Y1 - 1991/1/1

N2 - When fungi infect the bone marrow, typically they are associated with granuloma formation and/or necrosis, and the fungi are found within histiocytes or admixed with necrotic debris. Recently two bone marrow biopsy specimens were encountered in which fungi were confined to the cytoplasm of megakaryocytes, a finding not previously reported in the literature. The first case was that of a 46-year-old man with pulmonary histoplasmosis and no known immunodeficiency. The second was that of a 38-year-old man with the acquired immune deficiency syndrome and cryptococcal meningitis. In the first case, many megakaryocytes contained fungal forms consistent with Histoplasma. In the second, one small cluster of megakaryocytes contained several budding yeast consistent with Cryptococcus. Neither marrow biopsy specimen had necrosis, granulomas, or histiocytic infiltration. In both cases, because of the unusual localization of the fungi, they were initially overlooked. The bone marrow may contain fungi even in the absence of abnormalities suggesting fungal infection on routinely stained sections. A silver stain or a periodic acid - Schiff stain should be performed on all marrow biopsy specimens in cases of known or suspected fungal infection outside the marrow. The phenomenon of megakaryocyte emperipolesis is well known, and this process may be responsible for the apparent ability of megakaryocytes to internalize fungi.

AB - When fungi infect the bone marrow, typically they are associated with granuloma formation and/or necrosis, and the fungi are found within histiocytes or admixed with necrotic debris. Recently two bone marrow biopsy specimens were encountered in which fungi were confined to the cytoplasm of megakaryocytes, a finding not previously reported in the literature. The first case was that of a 46-year-old man with pulmonary histoplasmosis and no known immunodeficiency. The second was that of a 38-year-old man with the acquired immune deficiency syndrome and cryptococcal meningitis. In the first case, many megakaryocytes contained fungal forms consistent with Histoplasma. In the second, one small cluster of megakaryocytes contained several budding yeast consistent with Cryptococcus. Neither marrow biopsy specimen had necrosis, granulomas, or histiocytic infiltration. In both cases, because of the unusual localization of the fungi, they were initially overlooked. The bone marrow may contain fungi even in the absence of abnormalities suggesting fungal infection on routinely stained sections. A silver stain or a periodic acid - Schiff stain should be performed on all marrow biopsy specimens in cases of known or suspected fungal infection outside the marrow. The phenomenon of megakaryocyte emperipolesis is well known, and this process may be responsible for the apparent ability of megakaryocytes to internalize fungi.

KW - Acquired immune deficiency syndrome

KW - Cryptococcus

KW - Emperipolesis

KW - Fungus

KW - Histoplasma

KW - Megakaryocytes

UR - http://www.scopus.com/inward/record.url?scp=0025985583&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025985583&partnerID=8YFLogxK

M3 - Article

C2 - 1719795

AN - SCOPUS:0025985583

VL - 96

SP - 577

EP - 581

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 5

ER -